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Let go of the "one and done" mindset in type 1 diabetes

Consider the following. Would your perception of golf change if the only way you could score at the game was by striking a hole in one? There would be many scoreless ties.

What if rebounding wasn't allowed in basketball? If the ball doesn’t go through the hoop on the first attempt, then the other team automatically gets the ball back.

Imagine if tennis only allowed one service attempt, never two.

In such an alternate reality, these games would become ridiculously challenging, frustrating and frankly boring. Few persons would ever want to play, nor watch, these sports for very long.

Now think about this: a person with type 1 diabetes injects or boluses a single dose of rapid-acting insulin for a scheduled meal based on an estimate of the carbohydrate count in the food and a fingerstick blood sugar measurement. This person then expects (or has been taught to expect) an in range blood sugar result 2-3 hours later. Some persons with diabetes just inject a dose (omitting any carb counts or a BG measurement) and then eat, period. This is what many diabetics are taught to do: no extra opportunities to influence the blood sugar outcome are allowed except BG corrections (with food or insulin) well after the first action is complete.

If you appreciate the fallacy and frustration of the first three examples, then you must appreciate the folly of the final scenario. Formulas, ratios and sliding scales promote a belief in precision. That’s not always what happens. When blood sugar control is poor, it's often blamed on the patient, not how they were trained or which management strategy or philosophy was applied.

Persons with type 1 diabetes are first introduced to self-dosing their insulin in this fashion. It’s just a dosing algorithm. Many persons with diabetes become frustrated with the blood sugar results that often follow this overly simplistic “1 + 2 = 3” approach. 'One and done' rarely works in diabetes, yet many still cling to this outdated approach despite the existence of better methods. They may (wrongly) believe they are at fault every time.

"One and done" rarely works in diabetes"

Dynamic Diabetes Management, better known as Sugar Surfing™ embraces diabetes self-care like a pro golfer, tennis or basketball player masters the nuances of their respective games. They "manage the moment". Steering a ball or other object towards its intended target is what most sports are about. That takes skill. Skills can be practiced and rehearsed. Sugar Surfing is also a skill. A skilled Sugar Surfer steers and directs the flow of their blood sugar trends as they happen. The surfer uses a CGM or another frequent BG data source as input to make in the moment decisions to act or hold back based on the significance of the moment.

I encourage you to consider embracing a more dynamic approach to managing your type 1 diabetes. Leave the static-only world of diabetes self-care behind. Start by attending a Sugar Surfing Workshop, reading the book Sugar Surfing, or reading free posts on the website and scrolling through the archives.

Go to for all this and more.

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